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HomeMy WebLinkAboutMcCarthy, Robert 0,1 /�'igUFFote- ELIZABETH A.NEVII.LE o .. Town Hall, 53095 Main Road TOWN CLERK y Z P.O. Box 1179 1.4- yPry Southold, New York 11971 REGISTRAR OF VITAL STATISTICS N` y 1 MARRIAGE OFFICER �0! *�o SII Fax (516) 765-1823 RECORDS MANAGEMENT OFFICER ���•' ��� 991 Telephone (516) 765-1800 FREEDOM OF INFORMATION OFFICER OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL PERMIT CONSTRUCTION OR ALTERATION PERMIT SEPTIC TANK or CESSPOOL Permit No. 1910 R Residential X Non-Residential Fee $ 10.00 Septic Cesspool X PERMIT ISSUED TO: Name : MCCARTHY MANAGEMENT INC. Address 1 : 46520 ROUTE 48 City St Zip SOUTHOLD NY 11971 Descripton of Proposed Construction or Alteration SANITARY SYSTEM FOR SINGLE FAMILY DWELLING. APPROVED AS SUBMITTED AND AS APPROVED BY THE SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES. REF #R10-95-0054 Name Of Owner MCCARTHY, ROBERT J. Mailing Address 1 P. O. BOX 842 City St Zip SOUTHOLD NY 11971 Property Address 1 NORTH BAYVIEW ROAD City St Zip SOUTHOLD NY 11971 Tax Map No. section 79.00 block 2 lot 11 .000 Cross Street JACOBS LANE Building Permit Number Cross Reference: Issue Date: 8/13/98 Elizabeth A. Neville Southold Town Clerk (TOWN SEAL) ' N iii z • ,il�S�fFO(,(co / yw ELIZABETH A. NEVILLE 1� `Z G.y1; Town Hall, 53095 Main Road TOWN CLERK ; y P.O. Box 1179 Z Southold, New York 11971 REGISTRAR OF VITAL STATISTICS Orft Fax Fax (516) 765-1823 MARRIAGE OFFICER : # RECORDS MANAGEMENT OFFICER �,,l �� 1 Telephone (516) 765-1800 FREEDOM OF INFORMATION OFFICER '.� '. via OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD TO: Southold Town Building Department FROM: Linda J. Cooper, Southold Town Clerk's Office DATED: August 3, 1998 Transmitted herewith is a copy of application No. 1986 for a Cesspool/ Septic Tank Construction Permit submitted by: Thomas J. McCarthy Please review the application and location map and advise if the project has received Suffolk County Health Department approval and if this office may issue the permit. Please complete the form below and return it to me. Thank you. Linda J. Cooper * * * * * * * * * * * * I have reviewed the application and location map of the project cited above and make the following recommendations: APPROVE ,✓ DISAPPROVE Comments: A9 ignat r Dated r ; OFFICE OF THE TOWN CLERK OC§WF01/'`,D Tewn of Southold t(0 Judith T. Terry, Town Clerk Application No. i9 d b••••• Town Hall, 53095 Main Road c O: �� � Construction +P. O. Box 1179 Southold, New York 11971 ��, Alteration Telephone �� Residential 1� (516) 765-1801 Non-Residential TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL DISTRICT APPLICATION for CONSTRUCTION or ALTERATION PERMIT SEPTIC TANK or CESSPOOL • Permit No. Fee $ DATE APPLICANT NAME: fit WI' Aktf ' �� .r 1'lItittzple APPLICANT ADDRESS: 6S lO M L r au IID J 7/ SEPTIC CESSPOOL DESCRIPTION OF PR POSED CO STRt1 TION OR ALTERATION491\ air 0,1 LOCATION MAP: Must be attached hereto before permit may be issued. LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION: OWNER OF PROPERTY: , �- t, OWNER MAILING ADDRESS: OP S.u f10 iqj 88// r OWNER PROPERTY ADDRESS: C) �`Q U(� �: P. , v �-� /(77 / TELEPHONE NUMBER OF CONTACT PERSON: 765 -5815 TAX MAP NO. : Section 77 Block Lot (7 • CROSS STREET: fikif �t1 — ,TMats BUILDING PERMIT NUMBER CROSS REFEREN ._. ,( • favor /P Sign. of A. .lican RECEIVED BY: - -- "aw Clerk's Office DATE: U ' � _ WASTEWATER MANAGEMENT SUFFOLK COUNTY CENTER RIVERHEAD,NEW YORK 11901 (516)852-2100 • APPLICATION FOR EXTENSION;RENEWAL OR TRANSFER OF EXISTING PERMIT TO CONSTRUCT SEWAGE DISPOSAL AND WATER SUPPLY FACILITIES FOR SINGLE FAMILY DWELLING Before completing this application refer to"Instructions to Renew, Extend or Transfer an Existing Permit for Single Family Residence"on reverse side of this application. 1. EXISTING REFERENCE NUMBER Rto -- 7S -©OS y (If number is prefixed with 93-,9 - 91-,etc., a new application form [WWM-059] is also required.) 2. TAX MAP NUMBER: District Section 7? Block a- Lot t/ 3. NAME OF APPLICANT e0c0c4---,7 (If name is different from original applicant,see instructions for isferring a permit and completes f i 6 below.) ADDRESS 12 tC g Y)- sou C ) �� i q 7( PHONE /165-�/s 4. NAME OF AGENT(If not applicant) At�C'� ADDRESS 11654.Q � 71 DU !b PHONE 76-SEK 5. DATE OF ORIGINAL APPROVAL e-a 6-75 (If mote than 6 years old,a new application will be requinx1.) 6. TRANSFER OF PERMIT: I hereby transfer all rights and interest in the above referenced permit to the new applicant named above, SIGNATURE OF ORIGINAL PERMIT HOLDER/AGENT PRINT NAME DATE ADDRESS PHONE Application is hereby made to [ Jextend, [ 'renew, [ Jtransfer a permit to construct a water supply and sewage disposal system for a single familyresidence in accordance with the application, surveys and plans submitted. I hereby certify that I have examined the complete application and the statements therein are true and correct, and that all work shall be done in accordance with all applicable Town, County, State and Federal Laws and Codes. "Any false statement made herein is punishable as a misdemeanor pur • t to S21 .45 of New Y/i rk State Penal Law." SIGNATURE OF AP I E �'l ► - " + a'"�tI �_i .�. PRINT NAME CANT/AGNT DATE 1 T eC 4 VI TITLE li. If you are making substantia(revisions or modifications to a=pro•ject that hasalready received a permit to construct from the Department,or if the permit is more than six(6)years old,a new application will btractions as explained in`Submission Requirements For Single Family Residences' (WWM-0 11). 4144;4 its ar subject to any changes in standards enacted after the approval date of the original permit. JUN 12 1998 DEPARTMENT USE ONLY Dept.Of WUT astewater r Mg Office Wastewater Mgmt. , Permit is Extende wed Until _,a.�_� Q�j umber odrooms Approved N Pr• Signature of Department Representative 4 - 1 r Date 6 2 3-9 (1 WWM-104 (rev. 11197) u - -,.......------........— --% . jotfc cO. Hit tt '. IT,!* .4:•:-•• , • • - .^..VK \ C./11•0 di i • . • ,- ..,.,... ••'• :114V 1-4444•;. •'';:,t' \ / ,le"( H.S.' NO. r li, - .„- \ ale4 7 ! __---- - ----- i ' I‘ i S ‘ i . 0 \ MAP OF PAZOPERTY sTATEmorr Of INTENT THE WATER SUPPLY AND SEWAGE-DISPOSAL ., Schtv EYE 0 POZ SYSTEMS FOR THIS RESIDENCE WILL . 1 • 1.--- CONFORM TO THE STANDARDS OF THE. prot), cpoo 15 \1, 1 . R OBER ..1.T . Mc CART/4Y SUFFOLK CO. DEPT. OF HEALTH SERVICES. , ./..z.e.... , ‘ 1 (S) . , APPLICANT . *,- --„, in , ‘ . . i - ,,,-- 7 , `---,,, Ca e BAYVIEW SUFFOLK COUNTY DEPT. OF HEALTH r> tvl 6 t) ,' v . 4:+ hIl. ( d c a-A ,, ' v' - , 00" fik.:4,1 ra row"' 0 F ‘50U1-1-101.0 N. Y. SERVICES - FOR APPROVAL 4-- S1 CONSTRUCTION ONJDYN - - • . -- • ' .6. 1... , DATE: 2-6 , 3t)411\1 ‘ H. S. R . . 12/0-9 0054 41.01111AVINPV: #: tS.0 aid : 910 ' l'' AP- - 4 z i; -- • •dr IP ',-'41 "'"'" . 4 6 , '••• _,.. - .', •••••....momml•••••=0 , we k.. SUFFOLK CO. TAX MAP DESIGNATION ; ', No ‘,..,i. 4 . -*-5k• \ 0 t DIST. SECT. BLOCK, . c'poni , II • tZ4 •- ,, I , Area: /7, 464 621 . ft. t000 / --k. 's OWNERS ADDRESS: ' -;--,,1 - to k• , . , g \ i I/O. I Jed. tC) B 49 V14.10r - r• ti' 1 _ _ - ‹. A el = /74 t-1 UtriPtIi- ‘5041 tittold4 N. Y. tioli , - -- - 374 ' CD z. -....-4 VN ids- zgoili -1't 4e, 1 Ili 4:illo Pro/bootee f e'-'-'i j V4.7 ti'0.1 ii a.-fe t:rb.7744-4::-',1 1:-.-aeti Coeitri!! nttat;-i. . DEED: L. 6033 P. 120 , "‹. ' S. Well, ' .1. • 'Oi 4/4 in WO 414.111 / t\ . .. -* .., TEST HOLE - STAMP - 11 '" - - i ' - -'•1 • , , , `::. .\ t , , Unauthorized Natation oraddlOall , 0 .4 V) t , , ve& to thls survey is a violation of &COM 72013 of the New Yak Ststa '., NI - / s•• "_Atzp. - . _ Education Lava 7 ! . frl - ,. - • 1 ., -.s t. so 4.,,t'0411 t 1 .. C. • Copies of NS survey mai)not bearing - 41 ' ,10.2:WC 1 `CI > 1 ••• .... , Iv‘tn the land surveyoes Inked seal or 4 , L Z.\04 c4h•.4 embossed seal shall not be considered //CiAmended -tune 8, i'995- — - - ... 7 •:' to be a valid hue aNlY• ., Guarantees indicated hereon shall run , 1 eellfi,-; i .54.7%.4,.„ • 3'• /. 1 arepersoln fiahiwshomhurvey Ai 7343 . / s __ __ ___ 4PrePbeatt;0 . 2 i titecompr.governmental agency and lending institution listed hereon and to the assignees of the lenang kistl- Fit E", tution.Guarantees are not transferable Ai C) .7'H 13 iei r V14:-.- ^1 120417 ,:, to additional institutions Or subaqua* - •t. AI owners. /f'''• ., ..• 4•00,-..14 SEAL _ ,___. _ _______ __ .....<<• • 6,a ear/79 v) hi aAbed #.1'4,1.4-5 11995 0 .Z, I RO Q.ER ICJ( VANII,La, ‘A, _ 7 0.L LICENSED LAND SURVEYORS LAND '"- /I' . - 0 so-,,' '7 ,, \I '....... r. , . GREENPORT NEW YORK its•', , _ 1 '